STEC colitis mimicking acute severe colitis with life-threatening consequences: a case report.

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2024-01-01 DOI:10.51821/87.1.11652
T Hendrickx, M Peetermans, A D'Hoore, K Claes, A Van Hootegem, J Sabino
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Abstract

Acute colitis is a common feature of infection with Shiga-toxin producing Escherichia coli (STEC) and can mimic acute severe ulcerative colitis. Early recognition is important as there is a risk of developing Shiga toxin-induced haemolytic uremic syndrome (STEC-HUS), defined by the triad of microangiopathic haemolytic anemia, thrombocytopenia and organ damage. In severe cases STEC-HUS can cause severe neurological complications and can be fatal. We present a patient with a medical history of refractory ulcerative colitis, where making the diagnosis of STEC-HUS was challenging since the initial clinical presentation was difficult to differentiate from a flare of ulcerative colitis. This case illustrates that STEC induced colitis can mimic acute severe ulcerative colitis. This finding is of utmost clinical importance because of the potential life-threatening complications of STEC-HUS. Therefore it should be excluded promptly in patients with acute severe ulcerative colitis by using multiplex-PCR assay on a faecal sample.

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模仿急性重症结肠炎并危及生命的 STEC 结肠炎:一份病例报告。
急性结肠炎是感染产生志贺毒素的大肠埃希菌(STEC)后的常见症状,可表现为急性重度溃疡性结肠炎。早期识别非常重要,因为有发展为志贺毒素诱发溶血性尿毒症综合征(STEC-HUS)的风险,其定义为微血管病性溶血性贫血、血小板减少和器官损伤三联征。严重的 STEC-HUS 可引起严重的神经系统并发症,甚至致命。我们介绍了一名有难治性溃疡性结肠炎病史的患者,由于最初的临床表现很难与溃疡性结肠炎复发区分开来,因此诊断 STEC-HUS 颇具挑战性。该病例说明,STEC 诱发的结肠炎可以模拟急性重度溃疡性结肠炎。由于 STEC-HUS 可能会引发危及生命的并发症,因此这一发现在临床上极为重要。因此,对于急性重度溃疡性结肠炎患者,应立即通过粪便样本的多重 PCR 检测排除 STEC-HUS。
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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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